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Home My WebLink AboutPermit Electrical 2010-2-8 22S F;fth Street+Spr;ngfield, OR 97477+PH(S41)726-37S3+ FAX(S41)726-3689 1~:i;?Dltp.ARfMENT.. .:US'EONEy:'/1 ,,,:_,',,,'...'., J.::'~:"'~~'._'- -' .- ,..'. ...' ;', - ~. '-",. ",: '.' [permit no (/0 r 00 J~i Date :9/[(//0 Electrical Permit Application e D This permit is issued under OAR 918-309-0000, Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is s';spended for 180 days. I ~'1'{';c,<;,_;;. ;<;:~E_(jCAL:-~;GO~~_RNIVI_ENT:~A~FfROVA~~~~:~~fg!1f!t:::0~'?;':'1. ~~i~~;f,t~3ff~i~iy&:~if:gjl:~EEE~~,S~~H_E])"LJl2J;!1$~J~~l~f~~~~~tt~n I Zoning approval verified?' 0 Yes 0 No I :;N,~~~,~r.;~f;!j~fP~lrlg'~~;p,~[,,;;~.~'{L*f,lgif:I,;~~f~~~);I::!~~~~~:;~ 11~~,~!it~~\:t,,:~,c:ATEGORYitib!;;"CbNSTRUC'lUON~<'~1,::'jiii.......,:: I Residential. per unit, service inclu~,ed: ~~~~;~~~~~F"E'~IN~g~.~~;7;N;~N15~~~C~;~;;~I;~:;;i,:i;;111.000 sq. ft. or less (4) $134.00 $nlt,ool I Job site address: Jj 3 70 Md" ~ S-t I I ~~~oarltional 500 sq. ft. or portion $ 25.00 $ :1.5.~ I City: ~,,,r"c:,,,-U, I State: rAr- I ZIP:9'7>!7f I I Limited energy (2) $ 32.00 $ i1~efer:n~e: .f,~8~~&~~\;'~OF'WJ;~~~~~~,~},~..;,;:1 ~~~I~:nS~~~~~r~~ Fe~~:r (~)odular $ 63.00 $ I I...) I I I l I Services or feeders: installation, alteration, relocation I I:::,<~'nr,c..~ \ v-e-/l'lDCI~ I I 200 amps or less (2) $ B1.00 $ I I :PRbPERTY:OWNER '. . . I 20i'to 400 amps (2) $ 95.00 $ I I Name: Co......ID'i A..,a",lo;' '?acl'tc..' (......o"'i{\....I401 to 600 amps (2) $15B.00 $ I I Address: I q ."9 A.... thD"" W V I I 601 to 1,000 amps (2) $205.00 $ I I City: ~"c.~ne. I Stale: 0" I ZIP:'17Ito4 I Over 1,000 amps or volts (2) $469.00 $ I I PhoneS'!/ - tn 0770 I Fax: I Reconnect only (2) $ 63.00 $ I \ E-mail: I Temporary services or feeders: instqliation, alteration, relocation I This installation is being made on residential or farm property I 200 amps or less (2) 1 $ 63.00 $ I owned by me or a member of my immediate family. This I 20,1,'!0 400 amps (2) 1 $ B7.00 $ I property is nol intended for sale, exchange, lease, or rent. .OAR 479.540(1) and 47.9.560(1). I 4()T;19'600 amps (2) 1 $126.00 $ I Signature: I.Over 600 amps or'l~OOO volts, see services or feeders section above I I. .' "':;,,CONTRACliOR:INSTALl.ATION:, .' I Branch circuits: new, ai/era/ion, ex/ensionperpanel I \ Business name: A 1:..A P, elLl'- -\:- \1"'\ c.... _ I 1 a, Fee for branch circuits with purchase of a service or feeder fee: I I Address: ,')9<6 Ca.".::ad e. Dr. ", II Each branch circuit I I $ 6.00 I $ I I City: <;~,.., ",,"caJd I State: (J" I ZIP: 9 7 Ln ~ I b. Fedor branch circuits without purchase of a service or feededee: I I Phone:i4J-J;;~ 4' 0 1 I Fax: I' . Firstbranch circuit (2) $ 55.00 I $ I I E-mail: ,,,,,_ na\-.,..,C<..",(@.c..omLA<-~+~ i1~-t- I Each additional branch circuit $ 6.001$ 1 I CCB license no.: )'6SJl,:1 -I BCD license no.: ::H,1 i $' I Miscellaneous fees: service or feedernolincluded 1 I Signing supervisor's license no.: 1.":' i s D--fr".'1 I Each pump odrrigation circle (2) $ 63.00 $ . , I Print name Ofsi.gningSUpervisor: l1Je-t"'c5.r"''''' I Each sign or outline lighting (2) $ 63.00 $ I I Signature of signing supervisor: I "J.O ,.._ I Signal circuit or a IimitedMenergy pan'el, $ 63.00 $ I t...f " ..,.,.-~ alteration, or extension (2) I, E~.~.h_.dd;~i~nal_i:~~~cti_on:,~).. ....... J ,$SB~OO. $.1 ~ft!gf~~~2fiY~0~fAR~I1ICl\N1if~,l:J.SI:~1~ttf~;~~gf:~~ti~W;~.~<:~>~: I (A) Enter subtotal of above fees $. I'--~. oD (Minimum Permit Fee $58.00) /.;> I. I (B)Enter12%surcharge(.12x[A]) $ /q'Or' 1 (C) Technology Fee (5% of[A]) $ 7, I TOTAL fees and surcharges (A through C): . $/'ilI..O 'I, . , ~ ~~ .\\ ~ \,0\ ~,\o ~.~~ \\\ 440-2584.J (9108/COM) Status Issued 225 Fifth Street, Springfield, OR 541..726-3753 Phone 541..726..3676 Fax . 541..726..3769 Inspection Line Ul i' OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2010-00167 ISSUED: 02/11/2010 APPLIED: 02/08/2010 EXPIRES: 08/11/2010 VALUE: SITE ADDRESS: 4370 MAIN ST ASSESSOR'S PARCEL NO,: 1702323101915 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Electrical Remodel TYPE OF USE: New Public Owner: . PACIFIC CONIFERS LLC Address: 1959 ANTHONY WA Y EUGENE OR 97404 i CONTRACTOR INFORMATION J Contractor Type Electrical Contractor AZAP ELECTRIC BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: License n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: ._ I PUBLIC IMPROVEMENTS I Street ImprovementSnnrnON: Oregon 'awhre6r~9~~ i.iti\~ p. I adopted by t e ttorth Stl~rm Sewer A vail~bllllW ru eScenter. Those lu\eS are se ..001- SpeciallnstructionNollflcatlon 001..0010 through OAR 952, 8 bY in OAR 952- , 0 ies of the ru e Notes: 0090. You may obtain ~ofe: the te'~~hone . calling the cenler.. ( n Utility Notification . I. . - 'M th.. Orego .~.., ".... --Center \s 1-b'uy--'''---' .1 V.aluation Descriotion I Description $ Per S,q Ft or multiplier. Square Footage or Bid Amount Type of Construction Page I of2 Expiration Date Phone 541-505..460 I Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft B.asement: Sq Ft Garage/Carport Sq Ft Other: Occup~nt Load: :, REQUIRED PARKING , Total: Handicapped: : Compact: Sidewalk Type: DownspoutsfDrains; NOTICE: THIS PERMIT SHALL EXPIRE IF THE WO, IK AUTHORIZED UNDER THIS P~RMITjS NIIT COMME~ern.oR IS A8AMi:l~nrFrJR ANY 180 DAY pERIOD. r~.~.c~I~!ilIlI~~""""",," I ~ , ";" < ." {' CITY OF SPRINGFIELD Building/C<<;,mbination Permit . PERMIT NO: COM2010-00167 ISSUED: 02/11/2010 APPLIED: 02/08/2010 EXPIRES: 08/11/2010 VALUE: Status Issued 225 Fifth Street,. Springfield, OR 541..726-3753 Phone 541-726..3676 Fax 541-726..3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Residence Wiring 1000 Sq Ft Residence Wiring Ea AddU 500 Amount Paid Date Paid Receipt Number $19.08 $7.95 $134.00 $25,00 2/11/10 2/11110 2/11/10 2/11/10 3201000000000000045 3201000000000000045 3201000000000000045 3201000000000000045 Total Amount Paid $186.03 IPllln Reviews , To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be' made the same working day, inspections requested after 7:00 a.m. wilLbe made the following work day. Reollired Insnections I III.' I I I II I Rough Electric: Prior to Cover Final Electric: When all.electrical work is complete. Electric Service: Approval required prior to ntilitycompany energizing service. By signature, [state and agree, that I have carefnlly.examined the completed application'and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall'be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and lhat NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. [ further certify that only contractors and employees who are in compliance with ORS 701.005 will ,be nsed on this project. I further agI:ee to ensure that an required inspection'~1~~re req~ested at the proper time, that each address is readable from the street, that the permit card is located at the front of th'eproperty, and the approved set of plans will remain on the site at all times during construction. . . : Owner or Contractors Signatnre Date Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM20 I 0-00 167 COM20 I 0-00 167 COM20 1 0-00 167 COM20 I 0-00 167 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 3201000000000000045 Date: 02/11/2010 Description 'i:, ;'. '; '. Residence Wiring 1000 Sq Fl Residence Wiring Ea Addtl 500 + 12% State Surcharge + 5% Technology Fee Paid By AZAP ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received njm 470886 In J:erson Payment Total: "J: ,.\... Page I or I 2:31 :35PM Amount Due 134.00 2?00 19.08 7.95 $186,03 Amount Paid $186.03 $186.03 2/11/2010